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Combined hyoid bone flap in laryngeal reconstruction after extensive partial laryngectomy for laryngeal cancer

  • Head and Neck
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Abstract

Patients undergoing extensive partial laryngectomy require laryngeal reconstruction to restore function. Several techniques have been described, but they are associated with complications such as laryngeal stenosis. The aim of this study was to describe a new technique of combined hyoid bone and thyrohyoid membrane flap in laryngeal reconstruction after tumor resection, and to evaluate outcome. Eight patients requiring an extensive vertical or frontal partial laryngectomy for cancer were enrolled. Following radical tumor resection, laryngeal reconstruction was performed using the hyoid bone with a thyrohyoid membrane flap. Postoperative recovery time, complications, vocal quality, and cancer outcome were evaluated. The procedure was successful in all patients. There were no deaths, and no reports of postoperative dyspnea or dysphagia. Decannulation was performed in all patients after a median duration of 3 days (range 2–5 days). Swallowing and respiratory function were satisfactory and laryngeal stenosis did not occur during the mean follow-up period of 30.5 months. One patient had a local recurrence and required a salvage operation. A combined hyoid bone and thyrohyoid membrane flap is a reliable and relatively safe procedure that can be successfully performed for laryngeal reconstruction after extensive vertical or frontal partial laryngectomy.

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References

  1. Hartl DM, Landry G, Hans S, Marandas P, Brasnu DF (2010) Organ preservation surgery for laryngeal squamous cell carcinoma: low incidence of thyroid cartilage invasion. Laryngoscope 120(6):1173–1176

    PubMed  Google Scholar 

  2. Chone CT, Yonehara E, Martins JE, Altemani A, Crespo AN (2007) Importance of anterior commissure in recurrence of early glottic cancer after laser endoscopic resection. Arch Otolaryngol Head Neck Surg 133(9):882–887

    Article  PubMed  Google Scholar 

  3. Ganly I, Patel SG, Matsuo J, Singh B, Kraus DH, Boyle JO, Wong RJ, Shaha AR, Lee N, Shah JP (2006) Results of surgical salvage after failure of definitive radiation therapy for early-stage squamous cell carcinoma of the glottic larynx. Arch Otolaryngol Head Neck Surg 132(1):59–66

    Article  PubMed  Google Scholar 

  4. Nibu K, Kamata S, Kawabata K, Nakamizo M, Nigauri T, Hoki K (1997) Partial laryngectomy in the treatment of radiation-failure of early glottic carcinoma. Head Neck 19(2):116–120

    Article  PubMed  CAS  Google Scholar 

  5. Guerra AB, Miller LA, Soueid NE, Metzinger SE (2006) Laryngotracheal reconstruction using a rigidly fixated split clavicular myoosseous flap—a 10-year review. Ann Plas Surg 57(4):402–407

    Article  CAS  Google Scholar 

  6. McCaffrey TV (1993) Management of laryngotracheal stenosis on the basis of site and severity. Otolaryngol Head Neck Surg 109(3 Pt 1):468–473

    PubMed  CAS  Google Scholar 

  7. McCaffrey TV (1992) Classification of laryngotracheal stenosis. Laryngoscope 102(12 Pt 1):1335–1340

    Article  PubMed  CAS  Google Scholar 

  8. Service RF (2008) Tissue engineering. Coming soon to a knee near you: cartilage like your very own. Science 322(5907):1460–1461

    Article  PubMed  CAS  Google Scholar 

  9. Genden EM, Govindaraj S (2006) Allograft tracheoplasty technique for management of refractory tracheal stenosis. Ann Otol Rhinol Laryngol 115(4):302–305

    PubMed  Google Scholar 

  10. Cotton RT (2000) Management of subglottic stenosis. Otolaryngol Clin North Am 33(1):111–130

    Article  PubMed  CAS  Google Scholar 

  11. Langer R, Vacanti JP (1993) Tissue engineering. Science 260(5110):920–926

    Article  PubMed  CAS  Google Scholar 

  12. Neville WE, Bolanowski JP, Kotia GG (1990) Clinical experience with the silicone tracheal prosthesis. J Thorac Cardiovasc Surg 99(4):604–612 (discussion 612–613)

    PubMed  CAS  Google Scholar 

  13. Biller HF, Lawson W, Weisberg V (1986) Staged repair of extensive tracheal and laryngotracheal stenoses. Ann Otol Rhinol Laryngol 95(6 Pt 1):586–589

    PubMed  CAS  Google Scholar 

  14. Ward PH, Canalis R, Fee W, Smith G (1977) Composite hyoid sternohyoid muscle grafts in humans. Its use in reconstruction of subglottic stenosis and the anterior tracheal wall. Arch Otolaryngol 103(9):531–534

    Article  PubMed  CAS  Google Scholar 

  15. Bennett T (1960) Laryngeal strictures. South Med J 53:1101–1104

    Article  PubMed  CAS  Google Scholar 

  16. Cansiz H, Yener HM, Sekercioglu N, Gunes M (2004) Laryngotracheal reconstruction with a muscle-pedicle hyoid bone flap: a series of 23 patients. Ear Nose Throat J 83(6):424–427

    PubMed  Google Scholar 

  17. Omori K, Tada Y, Suzuki T, Nomoto Y, Matsuzuka T, Kobayashi K, Nakamura T, Kanemaru S, Yamashita M, Asato R (2008) Clinical application of in situ tissue engineering using a scaffolding technique for reconstruction of the larynx and trachea. Ann Oto Rhinol Laryn 117(9):673–678

    Google Scholar 

  18. Keghian J, Lawson G, Orban D, Remacle M (2000) Composite hyoid-sternohyoid interposition graft in the surgical treatment of laryngotracheal stenosis. Eur Arch Otorhinolaryngol 257(10):542–547

    Article  PubMed  CAS  Google Scholar 

  19. Wong ML, Finnegan DA, Kashima HK, Jafek BW (1978) Vascularized hyoid interposition for subglottic and upper tracheal stenosis. Ann Otol Rhinol Laryngol 87(4 Pt 1):491–497

    PubMed  CAS  Google Scholar 

  20. Finnegan DA, Wong ML, Kashima HK (1975) Hyoid autograft repair of chronic subglottic stenosis. Ann Otol Rhinol Laryngol 84(5 Pt 1):643–649

    PubMed  CAS  Google Scholar 

  21. Lim YC, Son EJ, Kim K, Kim KM, Choi EC (2005) Perichondrial flap to prevent chondritis and cartilage necrosis in salvage vertical partial laryngectomy for recurrent glottic carcinoma after irradiation: a new procedure. Acta Otolaryngol 125(6):659–663

    Article  PubMed  Google Scholar 

  22. Dursun G, Ozgursoy OB (2005) Laryngeal reconstruction by platysma myofascial flap after vertical partial laryngectomy. Head Neck 27(9):762–770

    Article  PubMed  Google Scholar 

  23. Apostolopoulos K, Samaan R, Labropoulou E (2002) Experience with vertical partial laryngectomy with special reference to laryngeal reconstruction with cervical fascia. J Laryngol Otol 116(1):19–23

    Article  PubMed  Google Scholar 

  24. Elo J, Horvath E, Kesmarszky R (2000) A new method for reconstruction of the larynx after vertical partial resections. Eur Arch Otorhinolaryngol 257(4):212–215

    Article  PubMed  CAS  Google Scholar 

  25. Alonso WA, Druck NS, Griffiths CM, Sumner HW, Ogura JH (1975) Cricoid arch replacement in dogs. Further studies. Arch Otolaryngol 101(1):42–45

    Article  PubMed  CAS  Google Scholar 

  26. McGuirt WF Jr, Little JP, Healy GB (1997) Anterior cricoid split. Use of hyoid as autologous grafting material. Arch Otolaryngol Head Neck Surg 123(12):1277–1280

    Article  PubMed  Google Scholar 

  27. Huang WC, Chen HC, Wei FC, Cheng MH, Schnur DP (2003) Chimeric flap in clinical use. Clin Plast Surg 30(3):457–467

    Article  PubMed  CAS  Google Scholar 

  28. Preciado D, Zalzal G (2008) Laryngeal and tracheal stents in children. Curr Opin Otolaryngol Head Neck Surg 16(1):83–85

    Article  PubMed  Google Scholar 

  29. Zalzal GH (1992) Stenting for pediatric laryngotracheal stenosis. Ann Otol Rhinol Laryngol 101(8):651–655

    PubMed  CAS  Google Scholar 

  30. Zalzal GH (1988) Use of stents in laryngotracheal reconstruction in children: indications, technical considerations, and complications. Laryngoscope 98(8 Pt 1):849–854

    PubMed  CAS  Google Scholar 

  31. Benito J, Holsinger FC, Perez-Martin A, Garcia D, Weinstein GS, Laccourreye O (2011) Aspiration after supracricoid partial laryngectomy: incidence, risk factors, management, and outcomes. Head Neck 33(5):679–685

    Article  PubMed  Google Scholar 

  32. Chevalier D, Piquet JJ (1994) Subtotal laryngectomy with cricohyoidopexy for supraglottic carcinoma: review of 61 cases. Am J Surg 168(5):472–473

    Article  PubMed  CAS  Google Scholar 

  33. Piquet JJ, Chevalier D (1991) Subtotal laryngectomy with crico-hyoido-epiglotto-pexy for the treatment of extended glottic carcinomas. Am J Surg 162(4):357–361

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Key Laboratory of Oncology in Southern China, Sun Yat-sen University Cancer Center, Guangzhou, 510060, Guangdong, People’s Republic of China

    Dian Ouyang, Xue-Wen Liu, Yan-Feng Chen, Jian Wang, Xuan Su & An-Kui Yang

  2. Department of Head and Neck, Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, 510060, Guangdong, People’s Republic of China

    Dian Ouyang, Yan-Feng Chen, Xuan Su & An-Kui Yang

  3. Department of Otorinolaryngology Head and Neck Surgery, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510655, Guangdong, People’s Republic of China

    Tian-Run Liu

  4. Department of Diagnostic Imaging, Sun Yat-sen University Cancer Center, Guangzhou, 510060, Guangdong, People’s Republic of China

    Xue-Wen Liu

  5. Department of Anesthesia, Sun Yat-sen University Cancer Center, Guangzhou, 510060, Guangdong, People’s Republic of China

    Jian Wang

Authors
  1. Dian Ouyang
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  2. Tian-Run Liu
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  3. Xue-Wen Liu
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  4. Yan-Feng Chen
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  6. Xuan Su
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  7. An-Kui Yang
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Corresponding author

Correspondence to An-Kui Yang.

Additional information

D. Ouyang and T.-R. Liu contributed equally to this paper.

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Ouyang, D., Liu, TR., Liu, XW. et al. Combined hyoid bone flap in laryngeal reconstruction after extensive partial laryngectomy for laryngeal cancer. Eur Arch Otorhinolaryngol 270, 1455–1462 (2013). https://doi.org/10.1007/s00405-012-2147-8

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  • DOI: https://doi.org/10.1007/s00405-012-2147-8

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